Thinking
Progressively:Using PALs
to Satisfy Your Patients

Progressive lenses are the lens of choice for presbyopic patients. Cosmetically, progressives provide the patient with visual fields for distance, intermediate and near, without the age revealing lines of a flat top bifocal or trifocal.

Visually, progressive lenses provide the best vision for all lifestyles; since a progressive has a prescription for all the field of vision in front of the patient, it meets all of their visual needs.

These are the same reasons that educated presbyopes are selecting progressive lenses more and more often. Because of this, ECPs have to be educate themselves on which progressives are out in the marketplace and how they relate to each other in terms of design, form and function.

Know the Lenses

Believe it or not, there are over 200 progressive lenses on the market, and a differentiating factor between ECPs is the amount of knowledge they possess that lets them dispense the lens most suitable for the patient’s lifestyle. Although it is impossible to commit to memory all the advantages and features of every progressive, it is important to recognize and know lenses manufactured by the larger companies. A few of these companies include Seiko, Hoya, Essilor, Signet Armorlite and
Shamir.

SeikoSeiko Optical Products, though it is not well known by consumers, is a world leader in the manufacture of progressive lenses and is responsible for many advances in progressive lens design. Seiko holds the patent on 100% back surface design, which it utilizes in its Succeed & Supercede free-form lens products. According to the manufacturer, these lenses:

“Utilize a perfect sphere on the front surface of the lens, which eliminates the front curve distortion that is responsible for the swim and sway effect many people experience when wearing PAL lenses. Seiko’s back surface design three-dimensionally fuses the patient’s entire Rx (sphere, cylinder, axis, add power and prism) onto the back surface of the lens, creating a visual experience that cannot be matched by conventional front-surface or split surface designs. Seiko PALs also provide intermediate and near zones that are up to 35% wider than conventional progressive lenses.”
(www.seikoeyewear.com)

Hoya
Hoya has progressives in numerous price points. These progressives include the Hoyalux™ ID, Hoyalux™ ID Lifestyle, Summit and GP Wide. All allow for greater peripheral vision and less distortion, but the most advanced progressive is the ID. The ID is a completely customized lens that follows the natural patterns and movement of the eye. The manufacturer states that:

“Our patented Integrated Double Surface Design (IDSD) process shapes the vertical component (which affects magnification and distance) into the front of the lens, and the horizontal component (which affects the power changes from side to side) into the back. The two surfaces are then integrated using Balanced View Control, our computer vision evaluation that analyzes and corrects any Skew Deformation, ensuring the clearest vision in all directions.”

In other words, vision is more stable. Previous non-adapts due to distortion or the “swimmy feeling” that sometimes occurs with a progressive should be able to wear the ID without feeling discomfort.
(www.hoyavision.com)

Essilor
Essilor is one of the most well known lens manufacturers today. Essilor has a wide range or progressives within its family and can fill up an article just on its own, but it’s important to know that they produce the Varilux® and DEFINITY® lines, as well as Natural, Adaptar, Accolade, and Ovation. Each lens has its own set of fitting rules and advantages.
(www.essilorusa.com)

Signet Armorlite
Signet Armorlite’s KODAK Unique Lenses are digitally-created backside progressives designed with Vision First Technology™. This technology provides a broad view in a clear distance area, smooth graduation of power for easy adaptation, gentle binocular balance for quick, clear object recognition and visual quality often compared to single vision lens. State-of-the-art technology is applied at each step. Corridor length is selected for each patient’s Rx based on the frame size and shape, monocular PD and fitting height. This ensures the best overall visual performance for nearly any B measurement, large or very small. This lens is available in 50 materials.
(www.signetarmorlite.com)

Shamir
Shamir uses a patented manufacturing process called EyePoint Technology®. A type of computerized lens surfacing, it calculates lens performance on multiple surfaces of the lens using index, prescription, center thickness, vertex distance as well as other factors. By utilizing this technology, the manufacturer promises greater peripheral vision and clearer vision.
(www.shamirlens.com)

Finding the Answer
With all the different lenses on the market, the ECP is bound to come up with something new and unusual. When this occurs, there are several resources available to help him or her find the information needed.

Online
There are several online communities where eye care professionals can ask and answer questions on progressive lenses, as well as other topics. The largest of these is Optiboard.
Optiboard.com is an online optical community strictly for the ECP. Although there are several forums available, there is one strictly for progressive lens discussion. Laramy-K Optical (www.laramyk.com) is another valuable resource available to the ECP. An independent optical laboratory, they have a website that has useful tools for identifying progressives. The main tool they offer is the Interactive Progressive Lens Chart application. It is an interactive lens database that has the progressive laser markings along power and adds ranges, as well as material availability. ECPs can also find an excellent resource at
www.opticianworks.com.

Publications
The Optical Laboratories Association publishes the Progressive Lens Identifier Book. This book helps dispensers identify a lens either by symbol, company, add range, minimum fitting height or lens name. It also includes a list of Trademarks and recently-discontinued lens designs.

Providing for the Patient
Now that the ECP has the information, it is now up to him or her to pass the information onto the patient in an easy to understand format. The most effective way to do this is to use Good, Better, Best, in which the Best is always explained first. When using this format, it is important to take the patient’s prescription, lifestyle, frame selection, and material choice into consideration.

Knowledge of the different progressive lines and how they fit and work is essential to the eye care professional. By knowing what progressives a patient is currently wearing and how the progressives in the dispensary compare, the ECP can exceed the patient’s expectations by providing the best vision possible.